NPI | 1659815884 |
---|---|
Former Name | TONYA KAITLYN CASTAGNA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110005626) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0110005626) |
Enumeration Date | 2016-12-07 |
Last Update Date | 2023-08-08 |